NHS Scotland recruitment crisis: Nearly two million agency shifts advertised last year, costing taxpayers millions

Nearly two million bank and agency shifts were advertised in NHS Scotland last year, costing taxpayers millions and providing further evidence “Scotland is in the grips of a doctor recruitment and retention crisis”.

Waits longer than 12 hours at A&E have reached an all-time high. Picture: Peter Byrne/PA

Medics have warned that “Scotland is in the grips of a doctor recruitment and retention crisis” as new figures show nearly two million bank and agency NHS shifts were advertised in 2022/23 – an “eye-watering” increase of 110 per cent over five years.

Statistics obtained from the Scottish Government via freedom of information requests show the number of these shifts across Scottish health boards has doubled since 2018/19.

Agency shifts are more costly to health boards than covering shifts with permanent staff, due to added agency costs and the need to attract people to work those shifts at short notice.

Agency shifts are more costly to health boards than covering shifts with permanent staff, due to added agency costs and the need to attract people to work those shifts at short notice.

In 2018-19, 104,794 agency and 841,629 bank shifts were advertised across the NHS. But in the most recent year, the figures soared to 464,495 and 1,520,227 respectively – 1,984,722 in total.

And in the period between April and May 2023, there had been a combined 403,733 bank and agency shifts advertised.

Dr Iain Kennedy, the chair of BMA Scotland, said he figures “demonstrate the impact” Scotland’s recruitment and retention crisis is having on the NHS.

“Agency shifts are expensive and not a sustainable way to staff our NHS, and it is undeniably worrying that the health service in Scotland is becoming more and more reliant on them,” said Dr Kennedy.

Health Secretary Michael Matheson has resisted calls to resign over his £11,000 iPad expenses bill (Picture: Jeff J Mitchell/Getty Images)

“Just days after our snap survey revealed that some 80 per cent of doctors who responded feel staffing levels are sometimes or regularly unsafe, this shows yet again how urgent a proper long term workforce plan for Scotland’s NHS is.

“We also need to finally properly value doctors at all stages of their career, and by investing in permanent staff, rather than temporarily plugging the gaps, the NHS could provide the continuity of care to patients that the evidence shows leads to better health outcomes.”

The Scottish Conservatives’ health spokesman, Dr Sandesh Gulhane, said the reliance on external staff was “deeply alarming”.

However, the proportion of these shifts being filled has fallen by 17.9 per cent in the five-year period. In 2018-19, 71.9 per cent were taken up, declining to 54 per cent in 2022-23.

Glasgow GP Dr Gulhane said: “The rise in the use of bank and agency staff on the SNP’s watch is absolutely eye-watering.

“While I know first-hand the important role bank and agency staff play in supporting our NHS, it is clear that the SNP’s dire workforce planning and mismanagement of our health service has left boards increasingly reliant on them.

“The fact that nearly two million bank and agency shifts were advertised last year alone is deeply alarming and a shameful reflection on the SNP’s record in charge on Scotland’s NHS.

“NHS resources are already at breaking point so the last thing health boards need to be doing is shelling out money on this scale to external staff to ensure shifts are fully covered.

“While SNP Health Secretary Michael Matheson is discredited and distracted by the multiple personal scandals surrounding him, he cannot let this situation continue. He must outline a proper workforce plan to reduce the dependence on bank and agency staff.”

Mr Matheson said: “Agency nursing is a tiny fraction of the £10bn a year NHS Scotland staffing pay bill and the majority of temporary staff come from staff banks – meaning these are NHS staff, working on NHS terms and conditions.

“New controls were introduced by boards from April 1 to begin to reduce the number of shifts being filled by agency staff and from June 1 boards are no longer using off-framework agencies, unless in exceptional circumstances.

“Boards have reported significant progress in reducing reliance on agency staff as a result of these changes and we are considering what further steps we can take.

“Since October 2021 more than £18m has been provided to recruit 1,250 international nurses, midwives and Allied Health Professionals by the end of this financial year, with around 1,000 successfully recruited so far.

“We absolutely value our nursing staff and have reached historically high NHS staffing as well as investing £1bn over two years on NHS Agenda for Change Pay which includes a 6.5 per cent pay raise for 2023/24.”